The Rhode Island Department of Health proposes a six-year data-based cancer control project for Rhode Island in collaboration with the state's cancer control community, its educators, and its youth leaders. Building on substantial evaluation and analysis of cancer control data sets and state plans for cancer control and health promotion, the Department proposes to begin this activity with five coordinated interventions aimed at reducing the prevalence of smoking among children and teens. Research has shown that when properly targeted, a comprehensive set of integrated interventions are effective in reducing cancer risks associated with tobacco use. Among the most useful interventions are school health education, media-based health education campaigns, self-help smoking cessation, physician-mediated smoking cessation, restrictive smoking policies, and tax disincentives. Although several of these programs exist in Rhode Island, data show that persons under the legal age to purchase cigarettes continue to exhibit a high prevalence of tobacco use, placing them at elevated risk of cancer and other diseases in later life. The Rhode Island Department of Health proposes to establish a six year initiative (three intervention years, three evaluation years) to reduce the prevalence of tobacco use among children and teens. These activities will complement existing cancer control and health promotion programs and are designed to create potential for continued financial support in the future. The proposed interventions include: (1) teenage smoking cessation programs in selected communities using the American Lung Association "Tobacco Free Teens" model; (2) voluntary, institutional tobacco-use policy initiatives for persons under legal age of purchase; (3) a statewide, media-based public information campaign for youth; and (4) an education and advocacy program for legislative leaders. A special planning component of the project will address a tracking and intervention system for high school dropouts, among whom the prevalence of tobacco use is high.